The gender and access to health services study: final report

Men and women frequently think and behave differently. To observe this is not to suggest anything so absurdly simple as that there are only male and female ways of being; behaviours and thought processes vary according to numerous other factors besides gender. That this is very generally the case however, does mean that there are broad - and often broadly predictable - differences in the way men and women engage with the world. Most commercial organisations understand this very well and plan accordingly. Many public authorities recognise it too and take these differences into account when developing and providing services. For historical reasons however the NHS has rarely done so. It is widely known that there are differences between men and women in the incidence and prevalence of most health conditions. Sometimes there are clear biological reasons for these differences but often there are not. Where biology offers little or no enlightenment, other questions need to be asked: · Do men and women behave in ways that predispose them to particular health conditions to different degrees? · Do men and women use health services with different degrees of effectiveness? · Do men and women receive differerent kinds of service from the NHS? The answer is – yes, these things happen frequently. This is sometimes to the disadvantage of one sex and sometimes to the disadvantage of the other. Sometimes it is to the disadvantage of both. And when these things happen, health outcomes are often affected. This report looks at the reasons why gender is such an important and fundamental determinant of health status and considers the ways in which gender inequalities can be tackled within the present legislative and policy framework. It also brings together the knowledge and evidence in relation to six specific areas of health concerns

Validity, reliability, acceptability, and utility of the Social Inclusion Questionnaire User Experience (SInQUE): a clinical tool to facilitate social inclusion amongst people with severe mental health problems.

BACKGROUND: Individuals with severe mental health problems are at risk of social exclusion, which may complicate their recovery. Mental health and social care staff have, until now, had no valid or reliable way of assessing their clients' social inclusion. The Social Inclusion Questionnaire User Experience (SInQUE) was developed to address this. It assesses five domains: social integration; productivity; consumption; access to services; and political engagement, in the year prior to first psychiatric admission (T1) and the year prior to interview (T2) from which a total score at each time point can be calculated. AIMS: To establish the validity, reliability, and acceptability of the SInQUE in individuals with a broad range of psychiatric diagnoses receiving care from community mental health services and its utility for mental health staff. METHOD: Participants were 192 mental health service users with psychosis, personality disorder, or common mental disorder (e.g., depression, anxiety) who completed the SInQUE alongside other validated outcome measures. Test-retest reliability was assessed in a sub-sample of 30 participants and inter-rater reliability was assessed in 11 participants. SInQUE ratings of 28 participants were compared with those of a sibling with no experience of mental illness to account for shared socio-cultural factors. Acceptability and utility of the tool were assessed using completion rates and focus groups with staff. RESULTS: The SInQUE demonstrated acceptable convergent validity. The total score and the Social Integration domain score were strongly correlated with quality of life, both in the full sample and in the three diagnostic groups. Discriminant validity and test-retest reliability were established across all domains, although the test-retest reliability on scores for the Service Access and Political Engagement domains prior to first admission to hospital (T1) was lower than other domains. Inter-rater reliability was excellent for all domains at T1 and T2. CONCLUSIONS: The component of the SInQUE that assesses current social inclusion has good psychometric properties and can be recommended for use by mental health staff

New Consequences of Induced Transparency in a Double-Lambda scheme: Destructive Interference In Four-wave Mixing

We investigate a four-state system interacting with long and short laser pulses in a weak probe beam approximation. We show that when all lasers are tuned to the exact unperturbed resonances, part of the four-wave mixing (FWM) field is strongly absorbed. The part which is not absorbed has the exact intensity required to destructively interfere with the excitation pathway involved in producing the FWM state. We show that with this three-photon destructive interference, the conversion efficiency can still be as high as 25%. Contrary to common belief,our calculation shows that this process, where an ideal one-photon electromagnetically induced transparency is established, is not most suitable for high efficiency conversion. With appropriate phase-matching and propagation distance, and when the three-photon destructive interference does not occur, we show that the photon flux conversion efficiency is independent of probe intensity and can be close to 100%. In addition, we show clearly that the conversion efficiency is not determined by the maximum atomic coherence between two lower excited states, as commonly believed. It is the combination of phase-matching and constructive interference involving the two terms arising in producing the mixing wave that is the key element for the optimized FWM generation. Indeed, in this scheme no appreciable excited state is produced, so that the atomic coherence between states |0> and |2> is always very small.Comment: Submitted to Phys. Rev. A, 7 pages, 4 figure

Cholesterol and coronary heart disease: screening and treatment

Coronary heart disease (CHD) is a major cause of morbidity and mortality in the United Kingdom, accounting for just under one quarter of all deaths in 1995: 27% among men and 21% among women.1 Although many CHD deaths occur among elderly people, CHD accounts for 31% of male and 13% of female deaths within the 45–64 age group

Frequency spectrum of gravitational radiation from global hydromagnetic oscillations of a magnetically confined mountain on an accreting neutron star

Recent time-dependent, ideal-magnetohydrodynamic (ideal-MHD) simulations of polar magnetic burial in accreting neutron stars have demonstrated that stable, magnetically confined mountains form at the magnetic poles, emitting gravitational waves at $f_{*}$ (stellar spin frequency) and $2 f_{*}$. Global MHD oscillations of the mountain, whether natural or stochastically driven, act to modulate the gravitational wave signal, creating broad sidebands (full-width half-maximum $\sim 0.2f_*$) in the frequency spectrum around $f_{*}$ and $2 f_{*}$. The oscillations can enhance the signal-to-noise ratio achieved by a long-baseline interferometer with coherent matched filtering by up to 15 per cent, depending on where $f_*$ lies relative to the noise curve minimum. Coherent, multi-detector searches for continuous waves from nonaxisymmetric pulsars should be tailored accordingly.Comment: 4 figures, accepted for publication in Ap